Evidence map›Paper›PMID 42646806›Full record

ArticleTropical medicine and infectious disease2026

National Implementation of a Tuberculosis Sample Referral Network to Expand Access to Molecular Diagnosis in the Republic of Congo: Pilot Evaluation and Programmatic Analysis (2023-2025).

Darrel Ornelle Elion Assiana, Hugues Check Asken Traoré, Franck Hardain Okemba-Okombi, Emmanuel Fonfon Ebata-Mboussa, Freisnel Hermeland Mouzinga, Erudit Beny Elenga, Asta-Wabi Fozia Hamed Belo, Mary Vincent Pabie Passy Mambou, Juliette Burchelle Ayessa Ondzie, Alain Disu Kamalandua and 12 more

Abstract read
In one paragraph

Article in Tropical medicine and infectious disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Darrel Ornelle Elion AssianaFaculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville P.O. Box 69, Congo.ORCID 0009-0007-2666-0719
Hugues Check Asken TraoréUnited Nations Development Programme, Brazzaville P.O. Box 465, Congo.
Franck Hardain Okemba-OkombiLaboratoire National de Référence des Mycobactéries, Brazzaville P.O. Box 1066, Congo.
Emmanuel Fonfon Ebata-MboussaLaboratoire National de Référence des Mycobactéries, Brazzaville P.O. Box 1066, Congo.
Freisnel Hermeland MouzingaFaculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville P.O. Box 69, Congo.ORCID 0009-0009-5838-6106
Erudit Beny ElengaLaboratoire National de Référence des Mycobactéries, Brazzaville P.O. Box 1066, Congo.
Asta-Wabi Fozia Hamed BeloLaboratoire National de Référence des Mycobactéries, Brazzaville P.O. Box 1066, Congo.
Mary Vincent Pabie Passy MambouLaboratoire National de Référence des Mycobactéries, Brazzaville P.O. Box 1066, Congo.
Juliette Burchelle Ayessa OndzieLaboratoire National de Référence des Mycobactéries, Brazzaville P.O. Box 1066, Congo.
Alain Disu KamalanduaUnited Nations Development Programme, Brazzaville P.O. Box 465, Congo.
Tanou Joseph KalivoguiUnited Nations Development Programme, Brazzaville P.O. Box 465, Congo.
Romeance Juvick LepoupouUnited Nations Development Programme, Brazzaville P.O. Box 465, Congo.
Bermeland Ewuinh TsiobindaUnited Nations Development Programme, Brazzaville P.O. Box 465, Congo.ORCID 0000-0003-2713-5872
Edrene Likoyo MampouyathUnited Nations Development Programme, Brazzaville P.O. Box 465, Congo.
Rachel Laure NguelaUnited Nations Development Programme, Brazzaville P.O. Box 465, Congo.
Viviane Gisele Lompo OuedraogoUnited Nations Development Programme, Brazzaville P.O. Box 465, Congo.
Prudence Théoline OvoulakaProgramme National de Lutte contre la Tuberculose, Brazzaville P.O. Box 1066, Congo.
Jessica Jeielle AyandeProgramme National de Lutte contre la Tuberculose, Brazzaville P.O. Box 1066, Congo.
Jacques Ndion NgandzienProgramme National de Lutte contre la Tuberculose, Brazzaville P.O. Box 1066, Congo.
Baurel Arnaud AkieraProgramme National de Lutte contre la Tuberculose, Brazzaville P.O. Box 1066, Congo.
Salomon Tchuandom BonsiLaboratoire National de Référence des Mycobactéries, Brazzaville P.O. Box 1066, Congo.ORCID 0009-0002-1055-005X
Jean AkianaFaculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville P.O. Box 69, Congo.

Funding

Global Fund to Fight AIDS, Tuberculosis and Malaria GC7
6 · The paper itself

Abstract

backgroundLimited access to rapid molecular diagnostics remains a major barrier to timely tuberculosis (TB) detection and drug-resistance surveillance in resource-constrained settings. In the Republic of Congo, GeneXpert MTB/RIF platforms remain concentrated in a few laboratories, while peripheral facilities rely predominantly on smear microscopy, highlighting the need for a structured sample referral system.

methodsWe conducted a three-year mixed-methods operational study comprising a six-month pilot phase (January-June 2023), initially enrolling 29 TB diagnostic and treatment centers in urban and rural settings followed by a 30-month national roll-out phase (July 2023-December 2025), evaluated retrospectively using routine programmatic surveillance data.

resultsDuring the pilot phase, 962 sputum samples were transported. 294 (30.6%) were TB cases, including 12 (4.1%) RR-TB. Median total turnaround time was 53 h (19-168) in urban and 62 h (26-204) in rural, with 86% overall site participation (92% urban vs. 60% rural). During scale-up, samples increased from 2154 (2023) to 5160 (2024), achieving full national coverage (12/12 departments). Over three years, 2587 TB and 84 RR-TB cases were detected. The system's contribution to national TB detection grew from 9.2% to 16.0%, and RR-TB detection from 10.4% to 18.7%.

conclusionsImplementation of the structured sample referral system was associated with improved equitable access to molecular TB diagnosis, turnaround times within national targets, and strengthened the RR-TB surveillance. Scalable transport networks integrated into national guidelines may enhance diagnostic equity and drug-resistance detection in centralized laboratory systems.

Indexed as

national scale-upRepublic of Congorifampicin resistancesample referraltuberculosisXpert MTB/RIF Ultra

Identifiers

PMID42646806
PMCPMC13517841

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.